Looking after your body the right way before and after having a baby can be quite confusing. There are a raft of opinions and recommendations coming at you from all directions and it is important to know which options are evidence-based and backed up by solid research, so our director Caitlin, who is herself 7 months post-partum, is here to clear a few things up.
Lately, I have read a few different articles around the place, with clinicians of different disciplines stating with conviction that different types of manual therapy can help with pregnancy pain, or even for those that seemingly have no symptoms, but are just pregnant! Now in some cases, this is true, but for the general pregnant or post-partum woman, this is not the case. And now that I am in the same boat as this population, I thought I would write a post to help clear up some confusion around this, and to try to help prevent any injuries coming from the wrong management or unnecessary treatment.
During pregnancy, and for a time following pregnancy, the hormones travelling around your body, cause all sorts of things to happen to your muscles and joints, specifically your ligaments. This serves a purpose, to help increase joint mobility to help the baby fit into a space it seems unfathomable that it will, and obviously, to get the baby out! But as these hormones, and the laxity that comes with it, hang around after pregnancy. At the same time, your abdominal muscles, which are incredibly stretched during pregnancy, remain stretched and therefore very weak and the only other muscles holding everything together, your low back and pelvic muscles, are extremely fatigued and therefore become weak themselves. This means that post-partum women are very vulnerable to ongoing pelvic and low back issues, as well as making it easier to injure yourself down the track, when it seems you have recovered fully.
So when I read that practitioners are treating these women for restrictions and tightness by using manual therapy, it makes me very concerned. If you think of a stool, with legs bolted on with screws. If we loosen these screws so they are still holding the stool together, but are quite loose, and then we put a fully grown adult on that stool, you can imagine how much the legs will wobble and strain under the weight. This is what is happening with your low back and pelvic joints at the end of, and following pregnancy. Now if we add in joint mobilisations and intense muscle releases to the picture, or in other words loosen the screws further…well, you see where I’m going! Not a good idea!
So, what should you do instead? Every post-partum women should make a point of strengthening! Not only their pelvic floor, but the other muscles that help keep your torso strong and moving well, the low back muscles and the abdominals. Now this strengthening is VERY gentle, and needs to remain so for a surprisingly long time. It seems to be the norm for women to think you can go back to high intensity exercise after 6-12 weeks, like they do on TV. It may be possible, but that doesn’t mean your body will thank you for it. It actually takes around a year to fully recover from pregnancy and child birth, so that’s how long you should take to build back to high intensity exercise! For this reason, I think it is important to get some advice from a physiotherapist regarding what exercises to start on and how to build these up as you go, and for this you should only need one appointment, just to get your questions answered. If you are having trouble post pregnancy, and are having ongoing issues with pelvic or low back pain, then you should definitely seek the help of a physiotherapist, as you will need a more specific and closely monitored rehab plan. It’s important to get on top of these issues during this first year, to avoid ongoing issues that are very hard to fix, especially if you go on to have more children.
I hope this helps to clear up some confusion about what is happening with your body since you’ve had your baby. If you have any questions, please feel free to give us a call to speak to a physiotherapist and see if we can help.